MISTY MICHELLE GROOM

BEND, OR
NPI1174891790
Former NameMISTY MICHELLE PEDERSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2011-12-09
Last Update Date2011-12-09
Business Address
-- MISTY MICHELLE GROOM
2577 NE COURTNEY DR
BEND, OR 97701-7638
Phone number: 541-322-7500
Mailing Address
-- MISTY MICHELLE GROOM
2577 NE COURTNEY DR
BEND, OR 97701-7638
Phone number: 541-322-7500